Retrograde approach for chronic total occlusion: present status and prospects
Masahiko Ochiai*, MD, FACC, FESC
Division of Cardiology and Cardiovascular Surgery, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
Chronic total occlusion (CTO) is defined as TIMI flow grade 0 within an occluded segment for an estimated duration of ≥ 3 months1,2. Such occlusions are quite different from recent myocardial infarction (MI) occlusions, for which percutaneous coronary intervention (PCI) has not shown superiority over optimal medical therapy in some prospective randomised trials3,4. Indeed, no randomised trials have ever been performed to evaluate the impact of PCI on “true” CTO. However, numerous non-randomised registry data clearly indicate an improved patient outcome after successful PCI for CTO5,6. Although CTOs are frequently found in patients who undergo coronary arteriography for known or suspected coronary artery ...